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Friday, March 20, 2015

Bubbles and Babes

Marissa reading Goodnight Moon to an adorable child on the ward.

When we first arrived to the Child Ward at Lewanika General Hospital we were told that we would be entering the ward at shift change or "handover." Naturally, we expected to see a gaggle of nurses standing around the nursing station discussing patients, with each nurse attempting to talk louder than the nurse beside her. To our surprise, unlike tradition in BC, the night shift nurses were walking around the floor with the oncoming morning shift nurses speaking at barely audible octaves in a language we did not recognize. As we struggled to hear or understand what they were saying, we realized we were not going to gain much about the many sick kids on the floor.

After the handover we went on rounds with the doctor, Dr. Idi. We had heard marvelous things about him and were excited to see him interact with the pediatric patients and gain all we could from his wealth of knowledge. Even though we couldn't catch much from the nurses, here surely we would gain some more information about the patients and their conditions. We arrived at the first patient and heard the doctor whisper "How is the child today Mummy?" to the lady sitting at the bedside of a child suffering with a severe case of malaria. The mother started to monotone whisper something back to the doctor, and at this point Marissa (who struggles to hear in the best of situations) leaned in so close to hear the response she tripped over the cart in front of her. Eventually we were able to adjust to the soft tones the Zambians speak in, and came to realize it made for a much quieter and more peaceful atmosphere on the ward.

The start of each assessment is done by asking that same question: "How is the child today?" The "mummy" or "father" is the person who sits at the bedside 24 hours a day and can be any kind of relation to the patient. We saw mums, dads, aunts, uncles, and grandmas. These people are responsible for the full care of the patient - even when medications are drawn up by a nurse they are handed to mummy to administer to the child. We were amazed by this aspect of care and dedication, and came to realize how much a family's life is impacted when a little one is sick. Mongu is a referral hospital for the area so many of these families have travelled days to get care. This means the family is without a parent back home, without an income, and their lives are greatly affected for the duration of the child's stay.

Throughout rounds (and louder conversations with Dr Idi) we learned so much of diseases we had not seen in Canada such as severe malaria, H.I.V. or R.V.D. as they call it here (retroviral disease), Hep A with jaundice, malnourished children, and many fractures.

The fractures intrigued us because when we came in we saw a lot of children in traction. This means their leg was held in place by a splint with a rope tied to end and there is a pillow case attached to the strong filled with sand. We assumed these children were waiting for surgery which is what would happen in Canada but we soon learned that this was their version of a cast. This child will lay in bed with the traction on until the bone has healed, and some of the children had already been on the ward for over a month.

There were positives and negatives about our experience on the ward. A couple things we didn't like: samples were drawn from infections on the kids (knees, scalp, and abdominal abscess) with a large syringe with no pain medication being given prior = a lot of crying and pain for children. This was very hard for us to watch, and we attempted to advocate for the patients and get them analgesia for the next time this occurs. Overall the severity of the very sick children in combination with low resources to treat their conditions fully was quite disheartening to say the least.

But there were pluses! And these outweighed the downs in our experience for sure. Marissa found when we brought out colouring books for the children, many or the parents did not know how to color in a picture from a coloring book. Teaching these parents to color was extremely rewarding, and it brought her near tears to she the joy and concentration on their faces as they colored away.

Sue found the most joy when she decided to blow bubbles for the children. After spending the week with some very ill children, the sound of one child's laughter and glee at trying to pop the bubbles warmed her heart in indescribable ways and reminded her and should remind everyone that this is why we do what we do.

Every picture the kids colored was taped up on the wall. It helped to brighten the ward and we loved seeing how proud the kids were of their creations.

3 comments:

Such a different way to doing things, especially when a whole family unit is affected by one member being sick! A true learning experience. To hear of such sickness/pain and limited resources and to be disheartened and want to fight for change is what makes you true nurses. What joy to teach them to color and blow bubbles. Such simple things that bring such joy. We can learn a lesson from them! Keep up the good work, everything you are doing is making a difference.

True nurses and true nursing indeed - that really says it all in a way. As you move forward in this experience, I really believe that all of you will find resources within each of you as people and nurses that you have never had to draw on before. And you will all be better people, and better nurses, for it.

Take care of each other as you go through these experiences. Listen to each other's stories and support each other through your healing work,

Marissa! I love seeing you in action! Peds is what I did in Zambia and it's heart wrenching and will change you forever and how you look at nursing care and life. The people there are so wonderful and amazing and strong! It's amazing what they get used to as normal and people here would complain about. Wish I were there with you all! Have a wonderful experience, love reading your stories!! Linda Linda Linda (Drew)